Introduction:
Coronavirus disease 2019 (COVID-19) has become a global health threat not only because of its acute phase, but because of the “long-COVID” that cause a substantial disease burden. Long-covid include also long-term consequences affecting patients’ wellness and quality of life. Our study aimed to assess the impact of long-covid on the patients’ quality of life in Tunisia.

Methods:
We conducted a cross sectional retrospective survey among a representative sample of COVID-19 survivors in Tunisia registered at the national SARS-Cov-2 surveillance database from September 2020 to September 2021. Trained health care workers interviewed consenting respondents by phone using a standardized questionnaire (EQ-5D-3L) including five dimensions: mobility, self-care, usual activities, pain-discomfort and anxiety-depression. Each dimension has three levels: no problem; some problem and extreme problems. Respondents recorded their perceived quality of life on a visual analog scale VAS (0-100). Alpha Cronbach was used to measure internal reliability of questionnaire’s item. We compared health-related quality of life between two groups: with and without long-covid.

Results:
Of 1094 persons contacted, 416 responded (38%). Long-covid prevalence was 64% (95%CI:59%-69%):128 (31%) of participants reported any problem in all dimensions: 41% among long-covid patients vs 13% among non-long covid (p<10-3). Compared to non-long covid patients, long-covid patients reported more problem on all dimensions: mobility: 14.8% vs 4.1% (p=10-3), usual activity: 12.6% vs 4.8% (p=0.01), pain-discomfort: 22.4% vs 3.4% (p<10-3) and anxiety-depression: 19.8% vs 8.1% (p=0.002). The VAS was significantly lower among long-covid patients compared to non-long covid: 73.1 vs 83.9 (p<10-3). Alpha Cronbach’s value was 0.66.

Conclusion:
Long-covid impact quality of life, affect mobility and cause disability. Psychological support during and after acute COVID-19 episode is recommended to preserve the well-being of affected patients. This additional burden shows the importance of the public health prevention measures and vaccine strategies.